Who is the target population for shortening prehospital delay in acute stroke?

Moalla, Khadija Sonda; Damak, Mariem; Chakroun-Walha, Olfa; Farhat, Nouha; Hdiji, Olfa; Sakka, Salma; Daoud, Sawsan; Kacem, Hatem Hadj; Rekik, Noureddine; Mhiri, Chokri

doi:10.1016/j.jns.2019.10.654

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“…Therefore, finding predictive markers in stroke patients would be very helpful for risk stratification, therapy selection, and prognosis evaluation. Age, the cause of the stroke, the etiology of the stroke, obesity, diabetes, heart disease, and hypertension are the main known prognostic factors for stroke (3,(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Body mass index has a non-linear association with three-month outcomes in men with acute ischemic stroke: An analysis based on data from a prospective cohort study

Zan

Xiong

Zhang³

et al. 2022

Front. Endocrinol.

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ObjectiveDespite reports of a connection between body mass index (BMI) and stroke outcome, the findings remain debatable. In this investigation, we sought to determine whether BMI was associated with the probability of 3-month unfavorable outcomes in patients with acute ischemic stroke (AIS).MethodsThis is a second analysis based on a cohort study. 1,897 people with AIS who were treated at a hospital in South Korea from January 2010 to December 2016 were included in the study. The linear relationship between BMI and unfavorable outcomes for AIS patients was evaluated using a binary logistic regression model. The generalized additive model (GAM) and smoothed curve fitting (penalized spline approach) were employed to see if there was a non-linear association between BMI and unfavorable outcomes in patients with AIS.ResultsThe binary logistic regression model did not detect any statistically significant correlation between BMI and unfavorable outcomes in AIS patients after controlling for variables. The association between them, however, was non-linear, with the BMI inflection point occurring at 23.07 kg/m2. Each 1 kg/m2 rise in BMI on the left side of the inflection point was linked to a 12% lower risk of unfavorable outcomes (OR= 0.88, 95% CI: 0.82 to 0.96, p = 0.003). We stratified the AIS patients by gender to further explore their relationship. The results showed a specific non-linear relationship and saturation effect of BMI (kg/m2) with 3-month unfavorable outcomes in male patients but not in female patients. The inflection point for BMI was 23.35 kg/m2. When BMI was below 23.35 kg/m2 in men with AIS, BMI was inversely associated with unfavorable outcomes (OR=0.89,95% CI:0.80-0.98).ConclusionA particular non-linear connection and saturation effect between BMI (kg/m2) and 3-month unfavorable outcomes were present in male patients with AIS but not in females. 23.35 kg/m2 was the BMI’s inflection point. The probability of unfavorable outcomes was substantially and inversely associated with BMI in men with AIS when it was less than 23.35 kg/m2. Men with AIS should have a BMI of no less than 23.35 kg/m2 to reduce the probability of unfavorable outcomes following AIS.

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